Ropa kudzvinyirira kuderera hakusi kusanzwisisika kusinganzwisisiki panguva yehemodialysis. Muhuru yezvokurapa, iyo intra-dialytic hypotension. Inogona kuva dambudziko rinokanganisa iyo inowanzoita kuti hopi dzisakundikana varwere vasina kuwana dialysis yakakwana nekuda kwekuregererwa kwekurapa kwemishonga. Inogonawo kutungamirira kumvura yakawanda yakasara kune varwere, izvo zvatinoziva zvinosanganiswa nehuwandu hwekufa kwekufa.
Risk Factors
Vamwe varwere vane mikana yekuona madonhwe anokonzera muropa ravo panguva ye dialysis. Kunyange zvazvo zvandinoona zvisingakwani sehupupuriro hunogamuchirika hwezvokurapa, kuongorora nokukurumidza kwemabhuku kunoratidza kuti vamwe varwere vanowanzoona kuwedzerwa kweropa kudonha.
- Vakuru vakwegura
- Varwere vanga vari pane dialysis kwenguva refu
- Vanorwara nechirwere cheshuga vanowanzova dambudziko guru
- Vakadzi vechikadzi
- Vose varwere
- Varwere vanoda kuwandisa zvakanyanya kuwanda kwekusvibiswa kwemvura, kana ultrafiltration, nekuda kwehuwandu hwe-di-dialtic weight gain
- Varwere vane uwandu hwakanyanya kuoma.
- Kutora ropa kumishonga yemishonga nguva pfupi isati yapfuura dialysis inowedzera ngozi
- Zvokudya munguva ye dialysis ndizvo zvinowanzozivikanwa
Nhaurirano pamusoro pekuti nei ava varwere vangava pangozi yakakwirira hakupfuuri munyaya ino. Zvimwe zvikonzero zvinogona kusiyana nehutachiona hwehutachiona muhutachiona (autonomic neuropathy), kukurumidza kushandiswa kwemvura panguva ye dialysis (iyo inogona kuitwa kuvarwere vane high-dialytic weight gain).
Izvi hazvirevi zvishoma asi zvinonyanya kukonzera kukonzera ropa muropa iro rinogona kuitika panguva ye dialysis iyo inosanganisira zvinhu zvakadai sezvirwere, uye zvinetso nemwoyo sechimiro chisina kujairika kana kunyange kutambudza mwoyo.
Zviratidzo nezviratidzo
Chikamu chakajeka ndechokuti intradialytic hypotension icharatidza sechichimbidzika kudonha muropa.
Zvisinei, varwere vanowanzonyunyutira maronda, kurwadziwa kwemuviri kana kurwadziwa kwepfupa, misoro, misoro, nezvimwe. Zviratidzo zve vagal nerve kukurudzira zvinowanzoonekwa uye zvinowanzouya sechiwande.
Kudzivirira
Intradialytic hypotension inogona kuva yakaoma yakaoma kurapa, kunyanya kune varwere vane njodzi dzakawanda zvinotaurwa pamusoro apa. Icho, saka, chinopera pasina kutaura kuti zvose zvinokonzera njodzi zvinhu zvinoda kuongororwa zvakasiyana. Dzimwe mazano angashanda ndeaya:
- Dzivisa kudya panguva ye dialysis
- Dzivisa kutora ropa kumishonga yemvura nguva pfupi isati yapfuura dialysis, kana funga kuchinja nguva
- Inobatsira kusawana kuwanda kwakanyanya pakati pekutevera dialysis mishonga; saka kuderera mukati-dialytic kuwedzera kwekubatsira kunobatsira. Iyo inonaya mvura shoma inoda kubviswa kubva kwauri, zviri nyore kuti urongwa hwako hwekuzungunuka hurambe huchichengetedza ropa.
- Nyanzvi yako yezvekodzero inogona kupa chirwere che dialysis zvakasiyana, neine yakakwirira ye sodium. Zvinyorwa zveizvi hazvisviki pane zvinyorwa izvi.
- Kana zviyero izvi zvikakundikana, taura nephrologist wako pamusoro pekuwedzera kuwedzera yako uremu hwakaoma
Kana zvakaratidzika semurwere ari kunonyorera zvinonzwisiswa nemirairo yakarongeka, uye hapana zvimwe zvinokonzera njodzi zvataurwa pamusoro apa zviripo, zvingava zvakakosha kuongorora mwoyo wemurwere.
Zvinetso nemwoyo basa haisi chikonzero chisingawanzokonzera madonhe muropa, uye murwere angabatsirwa nekuwana echocardiogram. Mune mamiriro ezvinhu, kuona chiremba wehupenyu kungava pfungwa yakanaka.
Mishonga inonzi midodrine inowanzoshandiswa sechisarudzo chekupedzisira. Uye kana chimwe chinhu chisina kushanda uye dambudziko rinowanzoitika, funga kuchinja ku peritoneal dialysis kana kumba hemodialysis.
Kurapa
Kazhinji, zvishoma zvishoma zvinokonzerwa nemvura zvinopiwa kwauri mune izvi. Izvi zvinogona kusanganisira zvinowanzosanganiswa semvura yakasvibirira sa saline chaiyo inowanikwa mune duku shous ya 250 ml kana zvakadaro. Kazhinji, vashandi ve dialysis vachaderedza kana kutomisa kushandiswa kwemvura kubva kwamuri zvakakwana munguva ino, uye iwe unogonawo kurongeka mune imwe nzvimbo yekuwedzera ropa kuhuropi, inonzi Trendelenburg nzvimbo (kushandiswa kwayo kunogona kushandiswa) .